Évaluation des apports alimentaires d’adolescents obèses et post-obèses : comparaison de la méthode iconographique SU.VI.MAX à la méthode de pesée des aliments

The objectives of this study were 1) to validate the SU.VI.MAX iconographic method against the weighed diet record method to assess food and nutrient intakes in obese and post-obese adolescents, and ; 2) to determine the effects of dietetic education on the precision of this method. Energy and nutrient intakes were determined by both methods in 26 institutionalised obese adolescents over 7-day-periods before the beginning and at the end of a weight-reduction programme, and 4 months later. The mean food, energy, carbohydrate, protein, and lipid intakes as assessed by the two methods were not significantly different, but the limits of agreement between the two methods were high. Obese and post-obese adolescents underestimated intake of their favourite meals (pasta, fried potatoes…) but often overvalued intake of vegetables, milk and hard cheese. The SU.VI.MAX iconographic method is, therefore, a reliable method to assess energy and nutrient intakes of obese and post-obese adolescents in epidemiologic studies, but it is unappropriate for assessment in individuals. In addition, dietetic education resulted in 50% decreases in the mean difference, and in the inter-individual differences in energy intake between the two methods.     

Facteurs associés aux consommations alimentaires des bénéficiaires de l’aide alimentaire : étude abena

The majority of data available on the nutritional situation of low socioeconomic populations in industrialized countries describe a diet that is less favorable for health. The objective of this article is to describe the demographic and economic factors associated with low food intakes as defined by the National Nutrition and Health Program (Programme National Nutrition Santé, PNNS) dietary guidelines in a food aid dependent population.Subjects from the Abena (Food and nutritional status of food aid recipients) study were recruited in four urban zones (Marseille, Dijon, Paris, Seine-Saint-Denis). Questionnaires were principally about food intake frequencies, food supplies and food insecurity.Among the 1,164 included subjects, low consumption frequencies of fruits and vegetables (94.5% consuming <3.5/day), meat, fish and eggs group (42.6% <1/day), and dairy products (81.9% <3/day) were found. Men, young and aged people, and individuals with dependent children seem to be more often at risk for inadequate intakes with regard to the PNNS dietary guidelines. The food insecurity (49.2% declared not having enough to eat “sometimes” or “often”) was associated with an insufficient intake of fruits and vegetables, and meat, fish, and eggs.The described factors associated with lower food intakes observed in this precarious population confirms the notion that fruit and vegetable, and meat, fish and egg consumptions are markers of the socioeconomic status. This has been already observed in studies on more various socioeconomic statuses. The nutritional situation of food aid recipients described here underlines the need for food aid improvement, eventually focused on specific groups which have been identified.     

A method to assess sodium intake in populations

Dietary sodium measurement in populations has severe limitations whether assessment is based on urinary excretion or on food intake methods. We have validated a simple instrument to determine total dietary sodium intake of populations in a pilot study of 10 women, 20 to 36 years old. Sodium intake determined by means of the sodium measurement instrument was correlated with sodium intake from food analysis, sodium intake calculated from food composition tables, and measurement of 24-hour urinary sodium excretion. Sodium values obtained with the instrument are based on regression equations, which incorporate information as follows: an average measure of 7 days' actual table salt use, the average sodium contribution of 17 high-sodium foods from a food frequency checklist maintained for 7 days, a calculation of drinking water sodium, and measurements of height and weight to establish 24-hour energy needs, a surrogate estimate of sodium found in all foods not included in the food frequency checklist. Participants were studied for 16 days: 7 consecutive days on either a 2,000-mg or a 3,500-mg sodium diet, 2 days' adjustment, and 7 days' crossover. Participants were allowed to select foods from a diverse menu, eat at fast-food restaurants, and consume alcohol if desired. Mean of 7-day sodium intake obtained with the instrument was significantly correlated with mean of 7-day sodium intake determined by food analysis (r = .80), from food composition tables (r = .62), and from urinary excretion (r = .56).     

Détecteurs de glucose et régulation de la prise alimentaire

Based on the glucostactic and lipostastic theories, it has been proposed that two dependent phenomena could be involved in the control of food intake. At short term, the regulation of food intake is part of the of the glucoregulatory mechanism, i.e. to the mechanism of use and replenishment of the glucose stores. This mechanism which is mainly involved in meal initiation is modulated by a second mechanism linked to the use and storage of lipids i.e. fat mass. Some molecules have been proposed to play the role of signal informing some brain structures of the metabolic status of the individual, among them leptin, insulin and glucose seems to play a major role. New insights into the cellular and molecular mechanism that support the fact that the electrical activity of some neurones depends on the glucose and/or insulin concentration, have been gained recently. Making the analogy with the beta cell of the islet of Langerhans, it has been proposed that proteins such as glucose transporter 2, glucokinase and the ATP-dependent potassium channel, could assure this sensing. Alteration in this sensing system could be at the origin of some alterations in feeding behavior.     

Consommation de produits laitiers et facteurs de risque cardiovasculaire dans l′étude MONICA

The aim of this study was to assess the associations between dairy products and cardiovascular risk factors in a representative sample of the French population. A sample of 912 men aged 45-64 years was randomly selected from the general population in Northern (Lille), Eastern (Strasbourg) and South-Western (Toulouse) regions of France. Risk factors were evaluated in each participant who completed a three-consecutive-day food record. In statistical analysis, subjects were separated according to quintiles of daily dairy product consumption. From the lowest quintile to the highest quintile of dairy product consumption and after adjustment for center, age, energy intake, alcohol, sodium, magnesium, and antihypertensive and antidiabetic treatments, systolic blood pressure significantly decreased. The prevalence of the metabolic syndrome decreased significantly from 32.6% to 25.0%, 21.8%, 18.3% and 19.9% (p=0.02 after adjustment for center, age, energy intake, alcohol, sodium, magnesium, and antihypertensive and antidiabetic treatments). In conclusion, high consumption of dairy products is associated with lower levels of blood pressure and a lower prevalence of the metabolic syndrome.     

La ghréline : seule hormone orexigène connue

Ghrelin is a 28-amino acid acylated peptide predominantly produced by the stomach peripherally as well as the pituitary and the hypothalamus in the brain. Originally discovered as the endogenous ligand of the orphan growth hormone secretagogue receptor, it is also involved in the regulation of food intake and body weight. Ghrelin is the first known orexigenic hormone. Human plasma ghrelin levels sharply increase before and decrease after every meal. Plasma ghrelin levels correlate negatively with the magnitude of energy stores. Obesity is characterized by low ghrelin plasma concentration, conversely patients suffering anorexia or cachexia display high levels. Weight loss triggers an increase in ghrelin levels while the opposite is observed during weight gain. The role for ghrelin in the regulation of appetite and body weight is mediated, at least in part, via the activation of neurons in the hypothalamus that coexpress neuropeptide Y (NPY) and agouti-related protein (AgRP), two anabolic neuropeptides. Ghrelin appears as the hormone that coordinates GH secretion and food intake to assure an optimal growth and a steady energy balance. Due to its role in the regulation of body weight, ghrelin holds promise as a target for both medical and surgical approaches to obesity treatment.     

Consommation alimentaire et durée d’hémodialyse chez l’insuffisant rénal chronique : corrélation aux paramètres nutritionnels

The aim of this study was to describe food consumption of CRF patients after different hemodialysis duration and to correlate them with some nutritional parameters. Fifty-eight patients divided into three groups: GI: <1 year, GII: 1 to 5 years, GIII: 5 to 13 years of hemodialysis were compared with 22 controls. Reduction of total energy intake by 47% and 30% and protein intake by 49% and 38% was noted in GIII vs GI and GII, respectively. Patients had a dialysis dose (Kt/V) of 0.83±0.35 and a low body mass index. Seventy-seven per cent of patients had hypoalbuminemia (<37g/L). Decreased food consumption involves protein-energy malnutrition and represents a mortality risk.     

Apports alimentaires et dépenses énergétiques d’adolescents footballeurs de haut niveau: comparaison de deux méthodes d′évaluation des apports

Food intake was assessed over 7 consecutive days in 14 adolescent soccer players (14.1 y; 1.65 ± 0.07 m; 55.4 ± 7.6 kg) housed in a training Centre equipped with a self-service restaurant, using the weighed diet record method and the SU.VI.MAX iconographic method. Nutrient intake was estimated using the software Prodiet^®. Daily energy expenditure (DEE) was assessed using a factorial method after a seven day activity record. Mean food and nutrient intakes were nearly adequate. However, intakes of starchy foods, fruit and vegetables were too low, whereas intake of sugar rich foods was too high. Mean saturated fatty acid intake was in excess, whereas PUFA intake was lower than RDA. Calcium, magnesium and iron intakes were close to RDA. Mean daily energy intake agreed with the mean estimated DEE. However, the high inter-individual variability in food choice, food and nutrient intakes, as well as food inadequacy during the weekend, must be underlined. The SU.VI.MAX iconographic method was adequate to assess energy and nutrient intakes in a group of adolescent athletes, but unappropriate for assessment in individuals. In addition, the adolescents underestimated intake of their favourite meals (starchy foods) and overvalued intake of fruit and vegetables.     

L’Homme, victime de son cerveau ?

Is the obesity pandemia resulting from an inadequate human physiology faced to a changing alimentary environment or is it the consequence of his own peculiarities leading him to build himself an unadapted environment, thus differing from animals like apes (monkeys)?We propose an enlarged conceptual organization of the regulation of food intake and body mass. It would imply four partners. The level of energy intake, metabolic energy utilisation, the level of fat stores and functional digestive ability. Each of these four players would be a controlled variable in relation to the three others and at the same time working towards their control in a system in dynamic equilibrium. They would be under the permanent control of a central integrator able to limit the variation of the center of gravity of the system in acceptable bounds relatively to an individual set point.A number of physiologic knowledges support this concept and we may insist on the role of visceral sensitivity and central integration. The refinement of the regulation of our integrity offering important adaptative mechanisms lead us to consider that human physiology is able to cope with usual changes of our alimentary environment.By exploring what coud differenciate humans from animals, particularly apes, the idea arises that humans could be victimized by his cognitive capabilities and more particularly by his communicative capabilities. Able to construct and to infer from incomplete knowledge he is capable to build up an unadapted environment driving him to destruction.Again, whatever their illusions human beeings cannot infrige their physiologic limits.     

Dietary sodium reduction among students: feasibility and acceptance

Modifications in the preparation of food served in a boarding high school during a 5-week period were successful in decreasing the sodium content of a variety of food products by an average of 51%. Such food was, in general, well accepted. The ratings of specific reduced-sodium food products equaled those of similar products containing "usual" amounts of sodium. Food diaries kept by students gave estimates of total sodium intake comparable with those measured by laboratory analysis of 24-hour food collections. Food diaries collected from an average of 70 volunteers per week indicated that during the reduced-sodium period, the total sodium intake of students, including that from dining hall food, snack food, and food consumed outside the school, decreased from 136 mEq (3 gm sodium, 8 gm salt) to 88 mEq (2 gm sodium, 5 gm salt), a reduction of 35% (p less than .0001). The impact of salt added at the table was very small; the choice and the quantity of foods consumed were the main determinants of sodium intake. The results indicate that foods can be prepared with appreciably less sodium and still be highly acceptable to young people.     

Sodium in the Finnish diet: II trends in dietary sodium intake and comparison between intake and 24-h excretion of sodium

OBJECTIVE: To estimate cross-sectional and long-term dietary sodium intakes and sources in Finland, and to evaluate the validity of 48-h recall to assess sodium intake. DESIGN: Cross-sectional dietary surveys and food availability data (Food Balance Sheets). SETTING: Dietary surveys were carried out in Finland in 1992, 1997 and 2002. Food availability data were collected from 1980 to 1999. SUBJECTS: A stratified random sample was drawn from the population register. The total number of participants in the three dietary surveys was 6730. In the subsample for urine collection, the number of participants was 879. INTERVENTIONS: Nutrient intakes were estimated on the basis of a 3-day food diary in 1992, a 24-h recall in 1997 and a 48-h recall in 2002. The 24-h urinary excretion of sodium was used to validate sodium intake. In addition, salt intake was estimated based on Food Balance Sheets. RESULTS: Sodium intake has slowly decreased since the early 1980s. Reported daily sodium intake correlated significantly with sodium excretion. CONCLUSIONS: Sodium intake has decreased during the last two decades, but is still higher than the recommended daily intake. Sodium intake estimation based on dietary surveys and food availability data is a valid method provided that the food composition database is up to date and of good quality. SPONSORSHIP: All surveys were funded by the National Public Health Institute in Finland and the Ministry of Social Affairs and Health.     

La collation matinale : fréquence, composition alimentaire et impact sur la nutrition des enfants

Morning snacks, initiated in the 1950's, tend to become a common practice among children, especially in nursery schools. To characterise this morning snack, food intake data from 624 children aged 3 to 10 years included in the INCA 1 survey and collected using a 7-day food record were analysed. Less than one child out of two had at least one morning snack during the week, generally between 10 and 10.30 am. Mainly composed of biscuits, pastries, or sweet beverages, this collation leads to an increased intake of carbohydrates, especially simple sugars. Moreover, this snack contributes to significant fat intake. Milk, the initial component of the collations, has become rare, and when it is present, it is always served with another food, principally biscuits. This supplementary intake during the morning was not associated with a low calorie breakfast and did not change energy intake at lunch. The repetition of this collation during the week leads to a higher average daily caloric intake. The presence of milk actually increases calcium intake, but few young French children are at risk of inadequacy for this nutrient. As a conclusion, a morning snack may contribute to unbalance children's diets and must be avoided, especially at school.     

Mécanismes de la dénutrition au cours de l'insuffisance respiratoire chronique

The study of the mechanisms of denutrition during chronic obstructive pulmonary disease is useful because this common evolutive complication has severe functional consequences and is associated with a poor prognosis, irrespective of respiratory functional status. Conversely, renutrition improves the prognosis in these patients. Adaptation to hypoxia, the basis of which is oxygen conformance, is described. Denutrition during chronic obstructive pulmonary disease is linked to the imbalance arising from increased energy expenditure and inadequate food intake. The origins of the imbalance are discussed. The clinical implications of knowing the mechanisms of denutrition are set out and perspectives for both experimental and applied research are proposed.     

Frequency of Sweet and Salty Snack Food Consumption Is Associated with Higher Intakes of Overconsumed Nutrients and Weight-For-Length z Scores During Infancy and Toddlerhood

BackgroundCurrent dietary guidelines recommend avoiding foods and beverages with added sugars and higher sodium before age 2 years.ObjectiveThe aim was to describe daily snack food intake (frequency and total energy) and the associations with overconsumed nutrients (added sugars, sodium, and saturated fats) and child weight-for-length z scores.DesignA cross-sectional, secondary analysis of baseline data from an ongoing longitudinal intervention was conducted.Participants and settingA sample of 141 caregivers with infants (aged 9 to 11 months) and toddlers (aged 12 to 15 months) was recruited in Buffalo, NY, between 2017 and 2019.Main outcome measuresThree 24-hour dietary recalls were used to categorize 'sweet and salty snack foods' or 'commercial baby snack foods' based on the US Department of Agriculture What We Eat in America food group classifications and estimate nutrient intakes. Child recumbent length and weight were measured by trained researchers.Statistical analysisDaily frequency (times/day), energy (kcal/day), and overconsumed nutrients from snack food intake were calculated. Multivariable regression models examined associations between the frequency of and energy from snack food intake with overconsumed nutrients and child weight-for-length z scores.ResultsInfants consumed snack foods on average 1.2 times/day contributing 5.6% of total daily energy, 19.6% of added sugars, and 6.8% of sodium. Toddlers consumed snack foods on average 1.4 times/day contributing 8.9% of total daily energy, 40.0% of added sugars, and 7.2% of sodium. In adjusted models including all children, greater frequency of sweet and salty snack food intake, but not commercial baby snack foods, was associated with higher weight-for-length z scores.ConclusionsSnack foods are frequently consumed by infants and toddlers and contribute to the intake of overconsumed nutrients such as added sugars and sodium. Given the current guidelines to avoid added sugars and higher sodium before age 2 years, additional recommendations related to nutrient-dense snack intake may be beneficial.     

Sodium and Potassium Content of Foods Consumed in an Italian Population and the Impact of Adherence to a Mediterranean Diet on Their Intake

High sodium and low potassium intakes are associated with increased levels of blood pressure and risk of cardiovascular diseases. Assessment of habitual dietary habits are helpful to evaluate their intake and adherence to healthy dietary recommendations. In this study, we determined sodium and potassium food-specific content and intake in a Northern Italy community, focusing on the role and contribution of adherence to Mediterranean diet patterns. We collected a total of 908 food samples and measured sodium and potassium content using inductively coupled plasma mass spectrometry. Using a validated semi-quantitative food frequency questionnaire, we assessed habitual dietary intake of 719 adult individuals of the Emilia-Romagna region. We then estimated sodium and potassium daily intake for each food based on their relative contribution to the overall diet, and their link to Mediterranean diet patterns. The estimated mean sodium intake was 2.15 g/day, while potassium mean intake was 3.37 g/day. The foods contributing most to sodium intake were cereals (33.2%), meat products (24.5%, especially processed meat), and dairy products (13.6%), and for potassium they were meat (17.1%, especially red and white meat), fresh fruits (15.7%), and vegetables (15.1%). Adherence to a Mediterranean diet had little influence on sodium intake, whereas potassium intake was greatly increased in subjects with higher scores, resulting in a lower sodium/potassium ratio. Although we may have underestimated dietary sodium intake by not including discretionary salt use and there may be some degree of exposure misclassification as a result of changes in food sodium content and dietary habits over time, our study provides an overview of the contribution of a wide range of foods to the sodium and potassium intake in a Northern Italy community and of the impact of a Mediterranean diet on intake. The mean sodium intake was above the dietary recommendations for adults of 1.5–2 g/day, whilst potassium intake was only slightly lower than the recommended 3.5 g/day. Our findings suggest that higher adherence to Mediterranean diet patterns has limited effect on restricting sodium intake, but may facilitate a higher potassium intake, thereby aiding the achievement of healthy dietary recommendations.     

Sodium Intake and Incidence of Diabetes Complications in Elderly Patients with Type 2 Diabetes—Analysis of Data from the Japanese Elderly Diabetes Intervention Study (J-EDIT)

This study investigates the associations between sodium intake and diabetes complications in a nationwide cohort of elderly Japanese patients with type 2 diabetes aged 65–85. Data from 912 individuals regarding their dietary intake at baseline is analyzed and assessed by the Food Frequency Questionnaire based on food groups. Primary outcomes are times to diabetic retinopathy, overt nephropathy, cardiovascular disease (CVD), and all-cause mortality during six years. We find that mean sodium intake in quartiles ranges from 2.5 g to 5.9 g/day. After adjustment for confounders, no significant associations are observed between sodium intake quartiles and incidence of diabetes complications and mortality, except for a significant trend for an increased risk of diabetic retinopathy (p = 0.039). Among patients whose vegetable intake was less than the average of 268.7 g, hazard ratios (HRs) for diabetic retinopathy in patients in the second, third, and fourth quartiles of sodium intake compared with the first quartile were 0.87 (95% CI, 0.31–2.41), 2.61 (1.00–6.83), and 3.70 (1.37–10.02), respectively. Findings indicate that high sodium intake under conditions of low vegetable intake is associated with an elevated incidence of diabetic retinopathy in elderly patients with type 2 diabetes.     

Does salt intake in the first two years of life affect the development of cardiovascular disorders in adulthood?

Excess salt intake impacts on blood pressure (BP) and the pathogenetic mechanisms of atherosclerosis predisposing to stroke and other cardiovascular disorders. The influence of salt starts early in life. Two randomized controlled trials in newborn infants suggest a direct association between dietary sodium intake and BP since the first few months of life. Newborn infants display aversion to the salt taste to develop a "preference" for salt only at age 2-3 years, in part in relation to post-natal events: this preference might be associated with later development of hypertension. The amount of sodium to be retained by an infant for proper physiological growth is largely covered by breast feeding (or low sodium formula milk) in the first six months, and later on by the gradual implementation of complementary feeding, without the need for any added salt upon food preparation. Given the lack of dose-dependence data, reference nutrient intakes (RNI) or adequate intakes (AI) for sodium have been established by national health institutions in various countries. The U.K. RNI was set at 242?mg a day for infants 0-6 months with gradual increase to?0.5?g up until age 3. The U.S. AI is somewhat lower for age 0-6 months but larger for age 1-3 years. According to a recent report, the average sodium intake in U.S. children is close to the AI up to age 2 years, to become progressively greater exceeding the Institute of Medicine recommendation later on.     

Dietary Outcomes of the ‘Healthy Youngsters,Healthy Dads’ Randomised Controlled Trial

(1) Background: The effect of fathers on dietary intake in preschool-aged children is under-explored. The aims were to: (i) evaluate the efficacy of a family-based lifestyle intervention, Healthy Youngsters, Healthy Dads, on change in dietary intake in fathers and their preschool-aged children post-intervention (10 weeks) and at 9 months follow-up compared to a waitlist control group and (ii) investigate associations in father–child dietary intakes. (2) Methods: Linear mixed models estimated group-by-time effects for all dietary outcomes, measured by food frequency questionnaires. Cohen’s d determined effect sizes, while correlation tests determined associations in father–child dietary intakes. (3) Results: For children, medium group-by-time effects sizes were identified at 10 weeks for sodium intake (d = 0.38) and percentage energy from core foods (d = 0.43), energy-dense, nutrient-poor (EDNP) foods (d = 0.43) and prepacked snacks (d = 0.45). These findings were sustained at 9 months follow-up. For fathers, medium to large, group-by-time effect sizes were identified at 10 weeks for energy intake (d = 0.55), sodium intake (d = 0.64) and percentage energy from core foods (d = 0.49), EDNP foods (d = 0.49), and confectionary (d = 0.36). For all of these dietary variables, except sodium, effects were sustained at 9 months. Moderate to strong associations existed in father–child dietary intakes for some of the dietary variables. (4) Conclusions: Although further research is required, this study provides preliminary support for targeting fathers as agents of change to improve dietary intakes in their preschool-aged children.     

Des qualités organoleptiques des aliments aux choix alimentaires

The sensory characteristics of foods are one critical factor of their palatability. The flavor of a food is determined by the perception of a complex set of sensory properties. Its palatability, the disposition to accept or reject the food, depends not only on sensory responses but also on previous experience of ingestion. A few acceptance or rejection responses are innate and are probably acquired during fœtal life. An individual hierarchy of preferences and aversions is acquired following the experience of ingestion of various foods, on the basis of a Pavlovian learning mechanism. Conditioned taste aversions are acquired for foods whose ingestion is followed by digestive malaise. Conversely, the postingestive experience of satiety determines the acquisition of food likes. Energy-dense foods, which induce strong satiety are usually very palatable for most people. Specific appetites also exist that correspond to the association between a particular food flavor and the satisfaction of specific nutrient needs. The notion of sensory specific satiety underlines the fact that satiety develops for the sensory characteristics of ingested foods, but much less, or not at all for foods with different sensory attributes, thereby facilitating the intake of a varied diet. This concept, whose brain mechanisms are being identified, stresses the importance of sensory factors in the control of food intake, in conjunction with internal, physiological factors.